The Kumasi Metropolitan Health Directorate saw increased cases of malaria and maternal deaths during the 1st half of the year [2013], presenting a huge worry to the health authorities.

The Out-Patients Department recorded 172 538 cases of malaria compared with the previous year’s [2012] same-period figure of 155 734. Maternal deaths totaled 73, 8 more than were seen in the 1st 6 months of the year 2012.

Dr Akwasi Yeboah-Awudze, the Metropolitan Health Director, said they are not comfortable with the situation and are doing everything to bring these numbers down. Addressing a mid-year performance review meeting in Kumasi on Friday [2 Aug 2013], he said they have stepped up malaria-control programmes in the metropolis including promoting the use of insecticide treated nets.

The cornerstone of malaria control is distribution of insecticide-treated bed nets, which use approximately 50 percent of the USD 115 million, the annual cost of the national malaria control program. The program is funded by the government, the Global Fund, World Bank, USAID/PMI, and WHO/UNICEF, with the Global Fund as the largest contributor. First-line treatment is artesunate and amodiaquine (AS+AQ), and 2nd-line treatment is artesunate and lumefanthrine (AL). According to the World Malaria Report 2012 Ghana country profile, both drugs have been shown to be equally effective, with a 28-day failure rate of about 14 percent, most probably due to re-infections after treatment.

A rise in malaria cases as reported could be due to a higher failure rate after treatment. One needs to know whether the malaria diagnosis was confirmed by microscopy or rapid test or was just presumed and treated. Secondly, if the rise in cases is due to a high failure rate after treatment (and the relapse counted as a new case), the quality of the drugs used for treatment needs to be investigated. – Mod.EP

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